摘要
目的 :探讨冠状动脉粥样硬化性心脏病心绞痛 (AP)患者血浆脑利钠肽 (BNP)浓度的变化及其临床意义。方法 :采用酶联免疫吸附试验 (ELISA)方法测定 2 0例 (对照组 )冠状动脉 (冠脉 )造影正常、心功能正常者及 5 5例AP患者静脉血BNP浓度。使用惠普SONOS 5 5 0 0型超声心动图仪 ,取胸骨旁左室长轴切面 ,测量左房内径 (LAD)、左室舒张末内径 (LVEDD)、左室收缩末内径 (LVESD) ,计算左室射血分数 (LVEF)。结果 :AP组血浆lg(BNP浓度 )明显高于对照组 (P <0 .0 1) ,其中LVEF <5 0 %的患者升高更明显 (P <0 .0 5 )。心功能NYHA≥Ⅲ级组lg(BNP浓度 )明显高于Ⅱ级组 (P <0 .0 1) ,NYHAⅡ级组高于Ⅰ级组 (P <0 .0 1) ,NYHAⅠ级组高于对照组 (P <0 .0 1)。稳定型AP组和不稳定型AP组lg(BNP浓度 )差异无显著性 (P >0 .0 5 )。冠脉病变 1支组、2支组及 3支组间lg(BNP浓度 )差异亦无显著性 (P >0 .0 5 )。AP组血浆BNP浓度与LVEF负相关 (r=- 0 .5 4 ,P <0 .0 0 1) ,与LVESD正相关 (r=0 .5 3,P <0 .0 0 1) ,与LVEDD、LAD相关性较弱 (分别为r=0 .4 0 ,P <0 .0 1;r=0 .39,P <0 .0 1)。结论 :冠心病心绞痛患者血浆BNP浓度明显升高 ,严重心衰患者表现更为明显。BNP浓度可反映左室收缩功能 ,与AP是否稳定、冠脉病变可能无明显关?
Objective: To explore variation and significance of brain natriuretic peptide level in pat ients with angina pectoris(AP). Methods: Fifty-five AP patients and 20 persons(contro l group) with normal coronary artery angiogram(CAG) and heart function were stud ied and CAG was performed in all patients. BNP in plasma specimens was measured with enzyme-l inked immunosorbent assay(ELISA). Results:The lg(BNP level) in AP group was higher than that in c ontrol group (P<0.01). It was more significant in the patients with LVEF<50%(P<0.05). The lg(BNP level) in NYHA class ≥Ⅲ patients NYHA class Ⅱ patients and NYHA class Ⅰ patients was higher than that in NYHA class Ⅱ patients NYHA class Ⅰ patients and control group,respectivel y (P<0.01, P<0.01, P<0.01).T here was no significant difference of lg(BNP level) between stable angina group and unstable angina group(P>0.05). There was no significant dif ference of lg(BNP level) among the patients with 1 coronary vessel disease,2 cor onary vessel disease and 3 coronary vessel disease(P>0.05).BNP level in AP patients correlated with LVEF(r=-0.54, P<0.001) an d LVESD(r=0.53, P<0.01)Conclusion:The plasma level of BNP increases significantly in A P Patients. It is more significant in patients with severe heart falure .The c h ange is likely not related with the stability of angina and the variation of coronary artery.
出处
《温州医学院学报》
CAS
2004年第5期365-367,共3页
Journal of Wenzhou Medical College
关键词
脑利钠肽
冠心病
心绞痛
心力衰竭
brain natriuretic peptide
heart failure
angina pectoris
